It looks like years of advice, promotion, guidance and initiatives about healthy eating and the importance of a healthy diet in the prevention of cancer, diabetes and heart disease might be slipping away from the public stomach! Despite the poor reputation of the nation’s diet there were some small improvements in the years reports prior to 2020. We significantly decreased our intake of sugary drinks (thanks to the governments industry levy) with corresponding reductions in overall sugar intake and also attained some small decreases in salt and saturated fat (see FSS report). Small trends in the right direction, with promise for impact on diet related disease?

Breaking good habits has clearly been a “covid-19 times” experience for many people. The latest report from Food Standards Scotland sets out what happened to shopping and eating habits during 2020 compared to pre-covid times through the various stages of lockdown and release. It spells out the work required to get back in the right direction of travel and how balancing our diets might be more about balancing our lives and our budgets. 

During 2020, the proportion of take-away meals that we purchased doubled when compared to 2019. The delivery market in Scotland gained 1.2 million new customers in 2020, an increase of 54% compared to 2019 but 66% consumers reported that it was difficult to eat healthily when ordering takeaway/delivery.

The success  of “eating out to help out”  to the UK economy was declared a success by the Conservative Party and so the struggle  between supporting the economy and health continues. Eating out means more than just feeding and there may be opportunities to select healthier options if mandatory calorie labelling is successful.  Scotland has a consultation open now on this very topic.

Finally, the home shopping trolley revealed that there was an increase in the amount of fat, sugar and salt purchased in 2020 in comparison to previous years.  These were accompanied by an increase in 19% of alcohol volume purchased from shops and supermarkets. This might be a habit that changes as people flood back to pubs but results from Kantar reported that we had a “not so dry January” in 2021 which saw the highest number of in home alcoholic drink occasions in the last 5 years.   

In the meantime, our levels of obesity have risen, despite the well evidenced association between excess body weight and the severity of covid-19, a problem that has not gone unnoticed by Obesity Action Scotland in their recent report. Their findings show that, whilst there have been some positive behavioural changes reported in the months between May 2020 and March 2021, the overwhelming message is of poorer diet quality, reduced physical activity levels, poorer mental wellbeing, and weight gain. Sadly, younger people and women seem to have been more affected by “covid-19 times”. The data show a very clear picture of how households with children face the greatest challenges .

Turning around these changes is unlikely to happen in an equitable way if we rely solely on education and calorie labelling. If we can reduce sugary drink intake by government action then we need to look to government for healthful action in our other dietary challenges including take-away meals. Positive action is needed now- including ways to severely limit junk food at every retailing opportunity – getting the nation back to health and reducing hospital waiting lists needs high priority action. Newly published review evidence in the British Medical Journal shows that changing the availability of foods and drinks have consistent and often substantial effects on consumer selection on choice and consumption with no evidence on increasing health inequalities. In other words, you can’t buy junk food if it isn’t there… time policy makers took note!

Professor Annie Anderson – Scottish Cancer Foundation